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HomeMy WebLinkAbout05-20-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT CLINE STEPHEN P 525 LAVINA DRIVE MECHANICSBURG, PA 17055 ACN ASSESSMENT CONTROL NUMBER --- fold ESTATE INFORMATION: ssrv: ooo-oo-oooo FILE NUMBER: 211 1-0603 DECEDENT NAME: CLINE MARILYN A DATE OF PAYMENT: 05/20/201 1 POSTMARK DATE: 05/19/201 1 couNTY: CUMBERLAND DATE OF DEATH: 04/30/201 1 AMOUNT 11132272 ~ 55.67 11132274 ~ 57.13 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK#1150 512.80 INITIALS: CJ RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EX111-961 NO. CD 014495 REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21-~~ -~~, Po Box 2so6ol - ~ `= TAXPAYER RESPONSE ACN 11132272 HARRISBURG PA 17128-0601 ,' ~; DATE 05-11-2011 REI~-1543~E% AFP C08-88) STEPHEN P CLINE 525 LAVINA DRIVE MECHANICSBURG PA 17055 EST. OF MARILYN A CLINE SSN 292-44-1006 DATE OF DEATH 04-30-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT © SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above named decedent, you were a joint owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 124449-00 Date 01-25-1992 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 7 9 5 . 7 1 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 132.62 months of the decedent's date of death, Tax Rate )( .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 5 • 97 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 C K g, ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART ~ and/or PART 3^ below. PART If indicating a different tax rate, please state OFFICIAL USE ONLY ~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Late Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 5 6. Amount Taxable 6 '~ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ 8 I PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID WORK C ) TAXPAYER SIGNATURE TELEPHONE NUMBER DATE TOTAL (Enter on Line 5 of Tax Computation) S Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME C ) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TaxES - AND FILE NO. 21 _~~ -4;~f, ~1:. Po Box zeocol ~='! TAXPAYER RESPONSE ACN 11132274 HARRISBURG PA 17128-0601 ~ DATE 05-11-2011 REV-1543 EX AfP (06-08) v , ~ 1... STEPHEN P CLINE 525 LAVINA DRIVE MECHANICSBURG PA 17055 EST. OF MARILYN A CLINE SSN 292-44-1006 DATE OF DEATH 04-30-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS © CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a point owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 124449-11 Date 08-19-2002 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance ~` 1 , 001 • 08 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 166.85 months of the decedent's date of death, Tax Rate )( .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential TaX Due $ 7 • 51 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state OFFICIAL USE ONLY ~ AAF relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE I. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 '~ 7. Tax Rate 7 X 8. Tax Due 8 PA DEPARTMENT DF REVENUE PAD 1 2 3 4 5 6 7 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME C ~ WORK ( ~ TAXPAYER SIGNATURE TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) S `7. ~ F USA 1 -C~'4S- ~~ ~~~~ ~~~_;~.~ f ~'f.~' - ~ ~' ~ ~ s ,. ~ ±,l ~a ~~ x X- rY~ ;~ ~ \ ~ ~ ~ -~ ~ " C~ ~ 4~ `~ ~ •~. ,~. ..~ .~ _.... ~~ o ~ Q-- ,~ S __~..._. .~ iT~ ~ ~ `'~ O ~ i=~ ~. ) ~. trf .,..} ~. ~~ ~- `~ ~~ ``. / ~ C ~ ~ i ,. ~ ,~ ~ _. ~ ~~ N L~